Organization
GROUP HEALTH PLAN INC
Active
Other names
HealthPartners
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ALAN DZIUK (SENIOR VP)
(952) 883-6535
Entity
Organization
Contact information
Practice address
5500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-2935
(952) 853-9120
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
(952) 883-5155
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
125J00000X
Dental Therapist
—
—
125K00000X
Advanced Practice Dental Therapist
—
—
125Q00000X
Oral Medicine Dentistry
—
—
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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